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General NPI Number Information
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NPI Number | 1245846187
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Entity Type | Individual
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Provider Name | ADAM BAKER PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 2440 W HORIZON RIDGE PKWY STE 130
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City | HENDERSON
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State | NV
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Zip | 89052-2731
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Country | US
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Telephone | 800-640-3451
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Fax | 385-287-1900
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Provider Business Mailing Address
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Address Line | PO BOX 1200
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-1200
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Country | US
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Telephone | 800-640-3451
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2561
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2561
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License Number State | ID
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